Endophthalmitis

Abstract

Endophthalmitis is asevere intraocular infection with potentially devastating consequences, such as becoming blind or loss of an eyeball. It can be exogenous (postoperative or posttraumatic) or endogenous. The most frequent causes of postoperative endophthalmitis are cataract surgery and intravitreal injections. Typical symptoms are pain and loss of visual acuity. Hypopyon and infiltration of the vitreous body with the loss of the red reflex are the most important clinical findings for endophthalmitis. The diagnosis is primarily clinical and supported by microbiological cultures and PCR from the vitreous body and/or anterior chamber and is of use for a targeted treatment. Treatment is acombination of intravitreal, systemic, and topical antibiotics, anterior chamber lavage, and vitrectomy. The decisive factor for the prognosis is the triggering pathogen. Infections with coagulase-negative staphylococci or Candida spp. have a good prognosis. Infections with Streptococcus spp., Bacillus spp. or Aspergillus spp. are unfavorable.